Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a brain-based behavioral disorder that affects one in 20 children,^[1] making it one of the most common chronic childhood disorders. Symptoms typically appear around age 7. For most people, symptoms continue through adolescence and adulthood.

Causes of ADHD have not been identified, but certain factors are strongly linked. Genes play an important role. Families with in which one person has the disorder are five times more likely to have another family member diagnosed.^[2] Gender is also strongly linked; boys are three to four times more likely than girls to have ADHD. Additionally, there are some dramatic differences in diagnoses for ADHD by region and race, with boys of color in the South and on the East Coast much more likely to be medicated than white children, or those who live in the West and Midwest.

A child with ADHD usually has trouble with three types of behaviors: paying attention, controlling impulsive behavior and hyperactivity, defined as “more than a normal level of activity or overactivity.” Children with ADHD struggle to control these behaviors, not for a lack of effort or willpower, but because the brain does not know how to regulate these behaviors. At school, students with attention disorders tackle their biggest challenges daily, so they can suffer academically, socially and behaviorally.

There are three types of ADHD school employees may see among students.

Understanding ADHD helps school personnel support students working to manage their symptoms. Typically, school staff may notice three types of ADHD:

1. Predominantly hyperactive-impulsive
These students show hyperactive and impulsive symptoms, but can regulate their attention. This type is not as common, affecting just one in 10 children with ADHD. Recognizable signs of hyperactivity and impulsivity include fidgeting, talking loudly, or having trouble staying in one seat and playing quietly. Additional impulsive behaviors include interrupting others, running and climbing in dangerous and risky ways, speaking without thinking, blurting inappropriate comments, and difficulty with containing emotions and waiting for their turn.

2. Predominantly inattentive
These students are inattentive but not disruptive or hyperactive, so this type is less likely to be noticed and diagnosed in a timely manner. Once, this type was labeled simply “attention deficit disorder” or ADD. Interestingly, girls with ADHD often have this type, which affects three in 10 children with ADHD. Signs of inattentiveness include difficulty listening, following instructions, focusing on and finishing work, and paying attention to details. Often, these kids are also forgetful and disorganized, so they lose things easily.

3. Combined inattentive/hyperactive/impulsive
This is the most common type of ADHD, affecting one in three diagnosed kids. All three behaviors—inattentiveness, hyperactivity and impulsivity—are present for a child with combined ADHD.

Children with ADHD face daily challenges, especially in school settings.

Instructional contexts require attention to multistep instructions, extended focus on a task, and long periods of quiet. A student with ADHD will find these expectations frustrating. The student may insist on talking, commenting and asking questions or may appear to drift off or daydream. Problems with impulse control can lead to arguments.

Children with ADHD find social and behavioral situations challenging. Compared with students unaffected by the disorder, they have three times as many peer problems and are 10 times as likely to have difficulties that interfere with friendships.[3] Interrupting others, difficulty with “filtering ideas” and overreacting are common behaviors, and a kid with ADHD is unlikely to understand how these behaviors can bother or affect others.

School personnel have an important role to play in helping children with ADHD succeed.

Qualified mental health professionals are responsible for a student’s treatment plan, often a combination of behavioral methods, psychotherapy and medication.[4] However, all school staff are in a position to provide meaningful support. Daily strategies can create health-promoting environments that help children with ADHD manage their symptoms.